When most people hear "pelvic floor physical therapy" they often think of going to an outpatient clinic for follow-up care after having a baby. However, pelvic floor physical therapists can provide important care and education for a variety of patients at different points in their recovery journey. In fact, I'd argue that they belong in an inpatient hospital setting as well.
Postpartum patients who are seen by a pelvic floor physical therapist before they go home from the hospital benefit from having the necessary education and tools to improve recovery after birth.
These patients learn how to manage pain, how to improve healing, techniques to establish proper bowel and bladder habits, and how to safely care for themselves and their newborns as they go about their daily activities.
Inpatient pelvic floor physical therapy is especially important for patients who have had Cesarean sections or experienced perineal tearing, as they will need additional education on caring for their scars to promote proper tissue healing; this education can include training on how to lift objects without putting too much stress on still-healing tissues, and scar massage techniques to promote optimal healing. Training how to lift objects and perform scar massage are beneficial for many patients. Anyone who has had abdominal surgery will need these techniques to ensure their recovery progresses properly.
Many patients staying in the hospital who are unable to get to the bathroom safely are provided with an external urinary catheter like PureWick. While these devices are convenient and improve patient safety, they can also promote poor bladder habits. Patients who have external catheters will often urinate whenever they feel the urge even if their bladder isn't full, simply because it is convenient to do so. However, our bladders are highly trainable and, when given the opportunity to void frequently, will fall into the habit of voiding too often. This becomes an issue when the patient goes home and is constantly rushing to the bathroom because their bladder has been trained to urinate too frequently. A pelvic floor physical therapist can provide guidance for these patients so they can do their best to maintain healthy bladder habits throughout their hospital stay.
Finally, physical therapists working in an inpatient setting are typically able to spend longer amounts of time with their patients than most other providers in the hospital. This gives them an opportunity to notice if something seems "off" with a patient's emotional state, and make the appropriate referrals for additional services. This is especially important with postpartum patients who may be experiencing postpartum depression. A pelvic floor physical therapist doing a postpartum evaluation is another opportunity for a healthcare provider to check on the patient in order to make sure they are safe to go home and will have the resources they need to be healthy and successful.
These are just a few of the ways that the specialized training of pelvic floor physical therapists can be utilized in an inpatient hospital setting to improve patient experience and outcomes. Other countries, like Australia, have already taken advantage of this resource by making pelvic floor physical therapy a standard part of postpartum care before the patient goes home. The practice is popping up in a handful of hospitals throughout the US, but it is time for us to make our voices heard so this valuable service can become available for all patients.
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